Brief Answer: Explained below. Detailed Answer: Hi, Welcome to Healthcare Magic! There are different kinds of mood disorders and not all people with mood disorders have bipolar disorder. People who have bipolar disorder have mood swings with some episodes of depression (low mood) and some of mania (elevated mood). Many people have a unipolar illness with episodes only of depression. They require long term treatment with an antidepressant. I guess you belong to the latter category and that is why, you have done well on either Pristiq or Wellbutrin which are antidepressants. People with bipolar disorder need a different kind of treatment, the mainstay of which is a mood stabilizer like valproate or lithium which prevents mood swings. Antidepressants are used only rarely in bipolar depression as they have a risk of causing a switch to mania. So it is only logical that your friend's treatment varies a lot from yours. In my opinion, if you were doing well on Pristiq, you should not go for a change. But if you really wish to change, there are many choices like going for a SSRI like Zoloft, Lexapro, Prozac etc or for a SNRI other than Pristiq, like Effexor. You can try any one of the many antidepressants available. But I still feel that the medicine which has done you good for two years should be continued and that too in the previous dose. You are under a lot of stress at this time and would need cover of an antidepressant to prevent the relapse of depression. Doctors sometimes make the worst of patients but they can also be the best of patients once they understand what is wrong and what needs to be done. I am sure you will become the best of patients once you understand better your illness and the treatment needed. If you wish, you can discuss this with a psychiatrist, as suggested by your friend. Hope this clears up things for you. Please feel free to ask if you need any clarifications. Best wishes. Dr Preeti Parakh MD Psychiatry

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